It sounds medieval, but it’s an accepted part of modern medicine: Maggots may assist in wound healing, French researchers report.

Maggots have been used to help treat wounds for thousands of years. Their use declined with the advent of antibiotics. Now, they seem to be making a comeback because of the alarming increase in antibiotic-resistant infections. Maggots may reduce the risk of wound infection because the larvae secrete substances that fight infection.

In the new study of 119 people with non-healing wounds, maggot therapy worked quicker than conventional surgical wound-cleaning during the first week only. There was no significant added benefit by day 15, though.

During the surgical procedure, the area is numbed and the unhealthy tissue in the wound is cut away.

Some maggot therapy practitioners place the maggots directly on the wound, where they remove dead tissue. In the new study, however, about 80 maggots were placed in a dressing over the wound twice a week for two weeks.

There was not much of a yuck factor. All participants were willing to try maggot therapy, says researcher Kristina Opletalová, a dermatologist at Caen University in France.

Donald S. Waldorf, MD, a dermatologist in Nanuet, N.Y., has never used maggot therapy, but he has seen them used. “They have been used on wounds since antiquity and especially in wartime,” he says in an email. “Their use seems to come in and out of favor. I can see using them when surgery would be medically difficult in very sick patients who cannot undergo anesthesia or when competent surgeons are not available. They clearly work to get rid of wound debris and may even clear out bacteria that grow on the debris.”

Maggots, Inc.

As the laboratory director and co-founder of Monarch Labs in Irvine, Calif., Ronald Sherman, MD, is the go-to guy for medical-grade maggots in the U.S. The FDA regulates the use of maggots, and they are only available via prescription here.

Sherman supplies 2,000 facilities in the U.S. with medical maggots. They are mainly used to treat diabetic ulcers and pressure ulcers, but can also have a role in treating post-surgery wounds that are slow to heal and may become infected. “These wounds are very, very serious and the doctor needs to make sure that [maggot therapy] is the right treatment,” he says.

Sherman reviewed the study for WebMD and says it “brings new data to the whole field.”

Maggots are not a last resort. “They are very effective, very inexpensive, and very safe relative to the alternatives,” Sherman tells WebMD. Surgery is the gold standard, but not all people are candidates.

Maggot therapy costs about $100, and some insurers will cover these costs.

source: webMD